Making Personal Health Data Available During an Emergency: HHS Ventures Fund Alumni Making Data Available When and Where it’s Needed

Major fault lines in Northern California

Major fault lines in Northern California

If you or your family were injured during a disaster like a hurricane, earthquake or forest fire, wouldn’t you want your health data to be available to first responders and others who are there to  provide care?

We thought you might, and we are partnering with the State of California to pilot just such a project.

Working at the Office of the National Coordinator for Health Information Technology (ONC), we have had the opportunity to leverage investments in health information technology to spur innovation in  public health and preparedness. We are especially excited about a project that had its beginning here at ONC but only really came to fruition thanks to a unique federal-state collaboration between the HHS Assistant Secretary for Preparedness and Response, the HHS Office of the Chief Technology Officer, and the State of California.  

The project, Patient Unified Lookup System for Emergencies (PULSE), received seed funding of $50,000 from the HHS Ventures Fund in July 2014. PULSE was designed to connect patients with their personal health records in some of the most challenging conditions imaginable – a natural disaster.

Here’s the update: the original HHS Ventures project (EMS to HIE Innovation), now known as PULSE, received an additional $2.75 million Advance Interoperable Health Information Technology Services to Support Health Information Exchange grant from ONC in July 2015.

In late 2015, the California Legislature passed and Gov. Jerry Brown (D) signed into law  four bills that support and extend the electronic exchange capabilities of the system to spread throughout the state’s 58 counties and 53 Congressional Districts.

Dr. Howard Backer, director of California’s Emergency Medical Services Authority (Cal EMSA), wrote last January that the “recent legislation, in addition to multiple data initiatives, is driving rapid changes in EMS data systems at the local, state and national levels.”

PULSE is currently being built to facilitate exchange during a declared emergency by extending interoperability across disparate technologies to support health information exchange. PULSE will allow Alternative Care Facilities (think of these as aid stations or MASH units set up during an emergency) so that EMS and authenticated volunteer providers can quickly get access to often life-saving data, when and where they need it. In the future, the PULSE system could facilitate patient lookup capability in an  ambulance.

During a recent demonstration by Audacious Inquiry, the contractor that developed the PULSE technology, the program’s benefits become readily apparent. In the event of an earthquake, or forest fire (like the one that recently ravaged Eastern Tennessee), first responders (defined under PULSE as any of six provider types, including doctors, nurses and EMTs) can query PULSE with standard eHealth exchange patient demographics—including name, date of birth, and gender.  PULSE then sends out data tendrils to California-based HIEs, health systems and hospitals, for instance, looking for a match to the query. PULSE then enables first responders to see recent care notes from treating providers – including hospital discharge summaries and the Consolidated Clinical Documents (CCDs).

As PULSE is being developed, we have tried to ensure that it can be a model for other states to use. To support future scalability, PULSE is utilizing industry standards when communicating with HIEs and hospitals.

To provide a glimpse into the impact of PULSE—it has the potential to ensure resiliency and redundancies in the world’s sixth largest economy, California.  PULSE will not only protect vulnerable patients but ensure that first responders and other providers have access to patients’ clinical documents at the point of care – a real limitation evidenced during Hurricane Katrina. This allows first responders and providers to make more informed clinical decisions for patients.

Cal EMSA is planning a “table top drill” to test PULSE’s capabilities in June 2017 – along with four connected HIEs that will process PULSE patient queries and return clinical documents – and will also hold its fourth annual California Health Information Exchange in EMS Summit which will include workshops and a “Fireside Chat” April 3-5, 2017 in Anaheim.  This conference is open to all to attend and will showcase cutting edge EMS and HIE projects from around the country.

Editor’s Note: Got a similar innovation story you want to tell? Let us know. Thanks for reading.

Innovation as a Problem Solving Tool in Government

A team supported by the HHS Ventures Fund developed a data-driven approach to public health emergency investments.

A team supported by the HHS Ventures Fund developed a data-driven approach to public health emergency investments.

The U.S. Department of Health and Human Services (HHS) faces an increasingly complex mission amidst rapid technological change.

It has been my honor to serve as the Chief Technology Officer (CTO), working with and supporting colleagues across HHS to improve operations and more efficiently deliver services to the American people. As I close out my time here, I’d like to highlight the accomplishments of our front-line public servants.

The Office of the CTO is charged with promoting innovation and open data across the Department. Our approach to the challenge of creating a culture of innovation is to help HHS employees and leaders shine a spotlight on a problem, and then invite people from the private sector to contribute their expertise. HHS employees also use our programs to test and develop their ideas in an entrepreneurial environment.

Our programs include:

Ignite Accelerator: Empowering front-line HHS staff to test new ideas

• 71 teams have participated, with 13 new teams starting their training on January 30.

Ventures Fund: Investing in and scaling internal innovations that dramatically improve HHS’s capabilities

• 11 projects supported, with a record number of applicants now being considered for the 2017 round.

Innovates Awards: Celebrating trailblazers from across the Department

• 50% of awardees had partnered with organizations outside of government.

Entrepreneurs-in-Residence: Recruiting outside talent to solve complex challenges

• 21 entrepreneurs have joined HHS to complete a tour of duty and we are currently recruiting for a systems architect.

Competes: Tapping into the ingenuity of the American people to solve problems

• 140+ prize competitions have attracted 9,000+ participants from across the U.S to source solutions.

Health Data: Unleashing the power of open data to improve health and human services

• 3,000 data sets are now publicly available, up from 30 in 2010.

Invent Health: Identifying emerging opportunities and challenges in health and technology

• Stimulated a national conversation on hardware innovation in health.

Buyers Club: Modernizing IT acquisition by testing new methods

• 100% of directly-supported projects awarded contracts to small businesses.

 

Read case studies and examples for each of these initiatives (PDF).

cover page for report "Innovation as a Problem Solving Tool in Government"

We have made significant progress in helping teams and individuals think of new ways to tackle important challenges. But there’s much more that can be done. As you read about each program, I invite you to consider how innovation and entrepreneurship might continue to help HHS better deliver on our mission to enhance and protect the health and well-being of all Americans.

Say What You Want To Say. The World Is Waiting.

two children laughing, playing, communicating

Sometimes a slap in the face (or a less painful equivalent to the ego) is a great wake-up call.  That’s how I internalized the importance and power of good communication.

I’ve always loved words and writing, but I would often over think my writing in certain contexts.  In a former life, when I was completing a degree in International Development, one of our initial assignments was to define “development.” Easy enough?  Well, in an effort to prove myself, I tried to sound as brilliant as possible with a super esoteric response that got me a, “See Me,” from the Professor in our Department who was most focused on the quantitative impact of international development interventions. Basically, a person that I thought cared more about the numbers.  In our meeting, he asked me to explain in words what I typed out.  After explaining in simpler, more authentic terms, he said, “Well, why didn’t you write that?” As I was leaving, he told me, “You owe it to the people you want to serve, to communicate in a way that they will understand.”  That has never left me.  It’s become essential to the way I view communications work.  It’s our responsibility but also a great privilege and opportunity to communicate effectively to the public around health and health care.

While there might be colleagues that reinforce the public stereotype of the apathetic government employee, we at the HHS IDEA Lab/Office of the Chief Technology Officer work with the opposite profile.  We work with mission-driven teams from across HHS who want to solve problems that would improve the way we serve the public.  They may need help in fleshing out the core problem and their ideas.  They might need more leadership support, a space to experiment, and access to tools and methods that would help.  But they are ALL committed to working smarter and more efficiently.

In my role as Director of Communications for two years and a newbie to federal government, I had the privilege of listening to and sharing out the work, insights and lessons learned from incredibly smart colleagues from across the Department.  At first, I questioned my role. With all of these experts in their respective fields, what value could I add?  Then one day, I found myself listening to a complex explanation of an immensely important project. That was just the beginning. I started to hear from more teams, more critical projects, more narratives that you had to ask questions and sit with more to really “get” as an outsider. And then, it clicked.  I’m here to help translate. I’m a bridge.

It has been my observation that communications work and activities are often considered a tool and an afterthought. This is felt more strongly in some sectors than others.  Yet with information coming at you today in so many different forms, with varying accuracy and at breakneck speed, I would argue that creative and compelling communication efforts that resonate with your audiences are even more critical.  Is it important to share your work, idea or innovation with consumers, with the world?  Do you want more engagement from the public? Well, communication is key to your success.

And if you agree, here are three key takeaways to remember:

Keep communication in mind from the beginning.  

If you are working on a project where outreach and communications may be necessary at some point, integrate that into your thinking and approach from the beginning itself. Involve your communications teams and available resources (if you have them) so they can plan and get creative early.  Identifying and understanding your goals, target audiences, key messages and desired actions in advance, might even influence the way you develop and implement your project.  

Make it easy. Keep it simple. It’s your responsibility.

We owe it to those we serve and support, to communicate in a respectful way that more people can understand.  It helps to take a step back and ask yourself – how would I explain this to a family member or friend that has no clue what I’m working on?  You might also consider stories that better illustrate the details and impact of what you are trying to convey.  Visuals can be compelling as well as metaphors that have the power to create a visual image with words.  E.g. This new platform will be the Facebook for X.   In other words, do your best to make your words and work accessible. It’s empowering for everyone.

Listen, be open and respond accordingly.

After you put out a blog or a tweet or a press release, use analytics and other feedback mechanisms to “listen,” and get a sense of what is working and adapt and adjust your approach accordingly.  As someone who enjoys communicating in different forms, it’s easy to get caught up in trying to perfect or want to follow a particular prescription of what activities you should undertake.  Resist the urge!  Every other day, a different digital platform or tool to share, crops up.  Stay flexible, experiment and let what you are hearing (using both qualitative and quantitative measures) guide you on the steps you take next.

Ultimately, your brilliant innovation, opportunity, idea, or message is just that – in lonely, isolation – without effective communication.  I know that there are many powerful examples of improvement and innovation that are happening within the walls of this Department to better enhance and protect the health & well-being of Americans. I had the honor of helping to communicate some of them.  

Let’s share them more and let’s share them well.

Modernizing our Public Health Surveillance Systems

Disease surveillance is the foundation of public health practice providing essential data to inform decision making and respond to health threats. In the past, surveillance systems were fairly simple and might require disease-specific data collection forms (paper or electronic) that were completed by epidemiologists and sent by fax or email, databases to store data that were often entered by hand, and tools to analyze and chart or map the data. Surveillance today is more complex. Data collection systems need to capture standardized data from electronic medical records or other sources, package that data into structured messages, transport the messages between systems, validate the messages for accuracy and completeness, unpack the messages and transform the data, provision the data into databases, and pull the data from the databases for analysis and visualization. And, it all needs to be done accurately and in near real-time, or as fast as possible. As an example, the figure below depicts the data flow for nationally notifiable diseases that are reported to CDC by state health agencies.

National Notifiable Diseases Surveillance System Data Flow

CDC’s surveillance systems serve critical public health functions but many of our systems use aging technologies that have been patched together over time and need to be rebuilt or replaced. We need systems that are less complex than the monolithic systems we use now, can easily be updated, and can be extended for multiple data collections purposes (see blog “Developing Forward Looking Software at CDC”). With this in mind, we are exploring technologies such as application programming interfaces (APIs) and microservices that are used successfully by many other organizations to deliver timely, high-quality data when and where it is needed.

The biggest challenge we face in modernizing our surveillance systems is not the technology; it is the changes that we need to make in our infrastructure and culture. We need to employ new methodologies such as agile development and DevOps for building, testing, and deploying our systems. We need to modernize our approach to IT governance to ensure systems and data are secure, and can handle automated iterative testing, discrete functionality monitoring, frequent deployment of software updates, and on-demand scaling. Equally as important, we need to enhance the IT workforce and change the way we procure and manage IT contracts. Current rules and funding cycles make it difficult to procure cutting-edge experience and expertise, coordinate across multiple IT projects, and transition systems from one contractor to another. Regardless of whether we build, borrow, or buy software, we need a workforce with knowledge of advanced industry standards and best practices to provide oversight of contract work and to make informed decisions about the technologies we need to build robust surveillance systems.

HHS IDEA Lab programs such as the Entrepreneurs-in-Residence (EIRs) are helping us to address these challenges. Our two EIRs—a software architect and a data architect—are creating an R&D team to pilot and test new software, developing a metadata repository to coordinate and standardize the data we collect, drafting architectural blueprints to guide future software development, and establishing new processes like DevOps to improve collaboration across the agency. The innovation and disruption brought by the EIRs has been just the spark we needed.

The modernization of our surveillance systems won’t happen overnight but we are moving in the right direction with the ultimate goal of providing the right data to the right person at the right time for effective public health action.

This blog was cross-posted from the CDC’s Division of Health Informatics and Surveillance (DHIS) Blog.

With Our Forces Combined

post it mosaic brainstorm at an IDEA Lab event

Results of white boarding session around why attendees came out during HHS Innovation Day (7/14/2016)

 

A new vision and approach to greater health calls for a world where everyone is a changemaker. Where everyone is empowered with that belief. Even government employees working in a corner of a large, hierarchical bureaucracy.

As a space that promotes innovation within the U.S. Department of Health and Human Services (HHS), we are at the crossroads of many “What if,” questions. What if we could promote the use of innovation across the Department to better deliver on our mission to enhance and protect the health and well-being of the public? What if we applied lean and design-centered thinking approaches to the critical challenges we encounter? What if red tape and the fear of failure didn’t stand in the way of a winning idea to improve efficiency? Our work begins with defining the problem, collaboratively imagining what’s possible, and helping teams as they navigate towards that vision.

Under the leadership of our Chief Technology Officer, Susannah Fox, our small but mighty team has had the privilege of supporting and listening to entrepreneurial ninjas both within and outside government. These teams and individuals are committed to harnessing the power of technology, data and innovation as a force for good in health.

We have supported some pretty awesome projects and efforts ranging from leading the charge to liberate health data from HHS agency vaults to transforming the organ procurement and transplantation system to making 3D printed biomedical models more accessible for medical research, discovery and care. As a government agency, we may never be at the cutting-edge of health innovation. We may as well face it. Yet, at the same time, WE ARE part of a complete vision of shaping a healthier world. And that’s why nurturing and growing creative thinking and action within government agencies like HHS is so important.

The IDEA Lab has worked with some incredibly fearless, mission-driven innovators within our Agency who are determined to hack red tape and better serve the public with little or no glory. We have also met amazing communities of entrepreneurs, scientists, makers, patients, clinicians, engineers and everything in between who are leading the way to better health, and creating the path as they go.

What if those superpowers came together and worked in greater synergy?

We look forward to imagining that “what if,” for health and medicine.

***

This is a modified version of a cross-post from the TEDMED 2016 blog


Interested in engaging in our efforts to hack red tape to better serve the public?  Great, we have two ideas in mind:

*For fellow HHS innovators and problem solvers, the HHS Ventures Fund is currently seeking to invest in proven, early stage solutions to better deliver on the Department’s mission. Learn more and apply today (thru December 20th).

*Sign-up for non-spammy updates from us on opportunities, events and generally what we are up to.

Thank you for your commitment!

Making It Stick: Applying HHS IDEA Lab Principles for Lasting Change

Think Outside the Box!

Like others who have participated in HHS IDEA Lab programs like the HHS Ignite Accelerator, I felt refreshed and inspired after learning the entrepreneurial, lean startup based concepts that are taught to teams. I practiced them regularly during my time in Ignite, but after the program ended, I felt the natural tendency to revert to the status quo back at my office. And I really didn’t want to let that happen. So, I didn’t.

To give a bit of context, I have been working as a software development project manager at the National Institutes of Health (NIH) for seven years. In 2013, I had the good fortune of being part of a project team that was selected for the Ignite Accelerator. Our project involved prototyping and then building an online repository for biomedically-relevant, 3D-printable files, called the NIH 3D Print Exchange. My responsibilities included fulfilling many of the project management duties for the team, but given the short timeline and the freedom to experiment within the Ignite framework, I was able to work in a less formal way than I normally had for my previous projects.

At some point early on in the Ignite program, I had a revelation. I think it had something to do with realizing that I was doing something for years that could be done differently (and done better). Or maybe it was that the methods being taught were becoming commonplace in the business world, and I learned that it was possible to adopt and apply similar ways of working within a government setting. Whatever it was, I decided to completely change how I go about my day-to-day work. And since 2013, I’ve diligently been trying to bring these changes into my organization. My primary motivation was that my old way of working was simply less effective than what I was doing within Ignite – and it was something that I never wanted to go back to.

Ignite’s “lean” approach may seem intuitive, but it was very different than the way I had been trained and even had become certified to work as a Project Management Professional. In the past, I would often painstakingly conduct upfront planning, formally gather requirements, and rigidly set schedules and budgets before starting a project that might last many months or even span years. I would follow standard processes and document everything meticulously. Yet, months into the projects, I would find that I had eschewed my plan, that my requirements had changed, and that I wasn’t meeting the original schedule and budget milestones. I often felt discouraged, and assumed I needed more training and practice. So I focused on trying to do the same things, but better.

My experience in Ignite made me realize that I had been working to refine what was, at least for me, the wrong approach. The formal processes simply didn’t fit with me or my organization, and I have come to accept that both I and my projects are better off if I adopt a new way of thinking and working.

So I shifted my focus to Ignite-based principles, and especially on spending time early on in projects doing the following:

  • developing clear problem statements and value propositions for stakeholders
  • creating, testing, and refining hypotheses continually
  • building prototypes or minimum viable products, using design thinking and related techniques, with the goal of getting the most critical components of the system “right”

All of this this led me to have more regular and meaningful communication with prospective users of the systems my teams were creating, to regularly solicit feedback from stakeholders on prototypes, and to reduce project risk by developing software in more bite-sized chunks rather than trying to build the entire system at once.

Around the same time as my Ignite project, I also came across a movement called agile software development that was gaining traction among professional software development groups, and that was related to lean startup. (Those practicing this methodology even have a manifesto!) Everything in my professional life started to converge, and my eyes were opened to what was, to me, a much more practical and effective way to do my job.

Looking back, I can say that these principles not only feel right, but they actually work! The NIH 3D Print Exchange project was developed more quickly and became more successful than any other project I’ve worked on. (In fact, it won numerous awards, was covered in dozens of media outlets, and even resulted in an invitation to an event at the White House to showcase our work!) Over the past few years, I have coordinated other development teams that have created other products using these Ignite-inspired approaches, and each has unequivocally displayed enhanced outcomes.

Based on this success within Ignite, I lobbied for broader adoption of these approaches across my 40-person office at the NIH, which has led to group training sessions, adoption of tools and techniques to support our new way of working, and the certification of multiple employees in the various roles associated with agile software development. I’m extremely optimistic about what our organization can achieve as we establish better ways of working by understanding our users and by applying agile, startup-based methods to our work.

I certainly cannot take full credit for this transformation, and I readily admit that I am very fortunate to work in an open, risk-tolerant work environment, with colleagues and managers who were receptive to, and who have become champions of, these new ways of working.

I urge those of you who have participated in Ignite – and even those who haven’t – to consider questioning the status quo and being open to these refreshing ways of working. While adopting lean/agile and design-thinking-based approaches may be uncomfortable at first, you just might find that something “clicks” for you as it did for me. If it does, I encourage you take the initiative to find ways to make these changes stick in your organization. While they won’t come overnight, I think you’ll learn a lot and ultimately find great benefits in making a similar transformation in your work!

If you want to explore this further, including additional strategies and examples of other transformations toward more lean and agile ways of working, both inside and outside the federal government, please sign up for the HackRedTape email list. Also, don’t forget to learn more and consider applying to the Spring 2017 round of the HHS Ignite Accelerator! (Applications are due November 14th!)

Changing the Knowledge Management Tides and Why it Matters: The Federal HR Wiki

people represented as nodes connected by internet/social media

 

by John Grill, Matt Gieseke, and Kelley Smith

John Grill is the Director of the Strategic Initiatives Group at the National Institutes of Health’s Office of Human Resources.

Matt Gieseke is a management analyst on the Strategic Initiatives Group, and heads up user engagement for the Federal HR Wiki.

Kelley Smith is a management analyst on the Strategic Initiatives Group, and is the project lead for the Federal HR Wiki project funded by the HHS Secretary’s Venture’s Fund Program.


Imagine this – a go-to member of your organization just retired, a furlough is approaching, and now no one knows what to do. What communications need to go out?  Who is considered ‘excepted’?  Can the daycare center stay open?  In the absence of mind-melds, how do you make expert knowledge easily accessible to newer team members?  The Strategic Initiatives Group (SIG) at the National Institutes of Health’s (NIH) Office of Human Resources was confronted with the specific challenge of how to transfer complicated programs to new owners with no familiarity, so their team decided to build a tool to solve their specific problem and a host of others along the way.  

The SIG team specializes in creating, innovating, and piloting new programs, then spinning them off to other Divisions to maintain. They regularly have to address the problem of how to take someone who knows nothing about a program, and get them up to speed quickly and effectively to ensure the program doesn’t suffer during the transition. The HR Wiki was the answer! The team built the HR Wiki – a user-friendly knowledge management tool for guides, processes, documents, and more. It is easy to use, both in creating content and consuming it, has excellent search functionality, and can be expanded to suit any office or type of work.  In addition to the tool itself, the SIG team has integrated the Wiki with existing processes and tools such as Excel, Visio, Google Calendars, Sharepoint, and more, ensuring that newly-hired employees have what they need to start contributing as soon as they arrive. Transitions facilitated by the Wiki have been so seamless that the HR Wiki team won approval to expand the Wiki tool to other parts of NIH’s Office of Human Resources.

It hasn’t always been easy.  While most embrace the importance of knowledge sharing and want to consume reference guides themselves, few feel like they can take time out of their already packed schedules to build guides for others.  The SIG team has devised strategies to make it easier for subject matter experts to put their expertise to paper.

First, the SIG team acts as a consultant and builds out rough draft pages that the experts merely need to tweak to finalize. The team also began convening “Wikithons,” which are fun, collaborative meetings where subject matter experts set time aside to create content pages while the SIG team provides technical support, content consulting, and tips and tricks. Not everyone needs this support, but many have expressed that they value these opportunities to learn tricks for collaboration, planning, and knowledge management.  

Once others in the Office of Human Resources saw the benefits of using the Wiki-like tool, more and more groups wanted to use it. That is when the Strategic Initiatives Group realized that they could help other organizations across government with knowledge management.  The barrier to this was funding; the SIG team needed support to begin the expansion of this project outside their small team.

When the SIG team learned about the HHS Secretary’s Ventures Fund program, it was a perfect fit for the HR Wiki.  The Ventures Fund provides growth-stage funding and support to HHS employees with innovative ideas for how to dramatically improve their Office, Agency, or the Department’s ability to carry out its mission and scale an innovation. After being selected as a finalist in the Ventures Fund program, the Federal HR Wiki has been able to grow and reach many more agencies than initially anticipated. Originally, this tool was used for knowledge management in a small team.  Now, the SIG team plans to open the interface up to 2,000 additional users—and you could be one of them!

Although current users are primarily within NIH, the SIG team’s goal is to expand it across the HR offices in the Department of Health and Human Services so that all HR professionals can share and benefit from the knowledge of their colleagues. The sky is the limit when it comes to the HR Wiki.  There are no technical barriers to expanding this tool to other business areas or even other Departments.

There has already been great interest in this from a number of federal agencies. Additionally, there is increasing interest in developing shared services across government, and realizing economies of scale. Most recently, in August 2016 the Modernization and Migration Management (M3) Framework has been promoted through the GSA as a way to streamline and share mission support services such as financial management and human resources across government. The Federal HR Wiki developed by the SIG team is a great example of how these efficiencies can be actualized.

Are you interested in exploring the possibility of using this new technology in your office? Feel free to reach out to the Federal HR Wiki team (OD-OM-OHR-OD-SIG@mail.nih.gov)!

How Cross-Agency Collaboration Can Work for the Greater Good

 

photo of puzzle pieces being put together

by Jeffrey S. Reznick and Brett Bobley

Jeffrey S. Reznick is the chief of the History of Medicine Division of the National Library of Medicine.

Brett Bobley is the chief information officer for the National Endowment for the Humanities and the director of the NEH Office of Digital Humanities.

Note: The original, full-length version of this article appeared in the July 2016 issue of The Public Manager, a unique digital publication published monthly by the Association for Talent Development about federal government leadership that works.


Collaboration between like-minded federal agencies doesn’t make good sense, it makes great sense—strategically, financially, and managerially. A synergistic collaboration helps agencies:

  • achieve their respective missions and serve the public effectively
  • leverage their resources and use them efficiently
  • foster creativity and teamwork
  • expand learning and professional networks.

Yet, as many of us working in federal government realize, something so simple in concept and function, is often quite difficult to execute successfully.

We’ve been able to find collaboration success through our work at the National Endowment for the Humanities (NEH) and the National Library of Medicine (NLM), by combining professional networks, advancing interdisciplinary research agendas, and making more widely known and publicly accessible a variety of research resources. How did we do this? What elements make up a successful interagency collaboration? Read on.

The Opportunity

Interagency collaboration can begin in different ways, mean different things, and involve a variety of activities, a report from the Congressional Research Service explains. Ultimately, the character of any collaboration depends on how it develops, why it exists, and who is working to achieve it.

The NEH is an independent grant-making agency in the executive branch dedicated to supporting research, education, preservation, and public programs in the humanities and in those social sciences that use humanistic methods. The NLM is the world’s largest biomedical library, also an executive-branch agency, and a unit of the National Institutes of Health of the Department of Health and Human Services.

Through conversations started via mutual connections, we learned about the work being done in our respective organizations specifically within the departments we oversee: the History of Medicine of the NLM and the Office of Digital Humanities of the NEH. From there, we established a joint interest and willingness to build something together under the well-known premise that two (or more) minds are greater than one.

Our key next step involved delineating clearly the complementary missions and interests of our agencies. This effort helped us define the roles of our agencies in a collaboration, how each could support the other in mutually beneficial ways.

The Office of Digital Humanities of the NEH supports research, education, collaboration, and interdisciplinary learning related to the broad and lasting impact of computers and technology on our culture and society. Its annual Digging into Data challenge is a unique program that supports humanistic inquiry into how digital technology is changing our world. Why, then, collaborate with the NLM? Primarily because it was a means to reaching a community of researchers who, as they study the history of medicine, are increasingly interested in methods and tools of the digital humanities.The NLM is a leader in the application of computer and communications technology to the advancement of health and improvement of the human condition. Its History of Medicine Division embraces the future as a steward of the past by documenting the history of human health and disease through a collection of traditional and 21st-century materials—from books to blogs, manuscripts to videos. Why, then, would it collaborate with the NEH? The methods and tools of the digital humanities, hold great promise to unlock the richness of these artifacts for the benefit of research, teaching, and learning about the human condition.

We also thought about the complementary resources each agency could bring to the table. The NEH could offer funding mechanisms in the area of digital humanities, a field that is increasingly of interest to historians of medicine and medical librarians who regularly use NLM historical collections, databases, and data sets. The NLM could offer deep connections into these communities, particularly through its National Network of Libraries of Medicine and its popular blog, Circulating Now. Additionally, the NLM could offer the resources of its History of Medicine Reading Room and state-of-the-art meeting space at the National Institutes of Health.

The Solution

By looking critically at what each of our program areas could contribute to a collaboration, we defined the terms of the memorandum of understanding between our agencies.  Securing the support of our leadership was essential as we defined these terms, as was emphasizing the strategic value of the collaboration for both agencies and the relatively minimal financial cost of working together.

Another step in crafting this memorandum was close cooperation with our respective executive offices, specifically legal counsel, to ensure mutual agreement on the format, content, and intent of the document.

Integral to the development of our collaboration has been our rapport, our mutual respect and support, and our clear and consistent communication. We modeled this relationship with and for our respective teams so that they also would contribute their skills to partnering with each other and with the other organizations that have become a part of our collaboration. Admittedly, the top-level support we received was a linchpin to our success, but our strong rapport has been—and remains—a key factor in the success of the initial collaboration and its subsequent reaffirmation.

The Results

Between 2013 and 2015, we worked with a network of national and international partners to convene two well-received symposia and one hands-on workshop, all to the end of creating and supporting an international conversation about big-data approaches to research in the humanities and social sciences.

Our collaboration took root around Shared Horizons: Data, Biomedicine, and the Digital Humanities, an international symposium held in April 2013, funded by the NEH through a grant to the Maryland Institute for Technology in the Humanities of the University of Maryland, and co-sponsored by the NLM and Research Councils UK.

Shared Horizons, which has garnered widespread praise, brought together researchers from the digital humanities and bioinformatics communities to explore collaboration, research methodologies, and the interpretation of evidence arising from the burgeoning area of “big data” and biomedical-driven humanities scholarship. The success of Shared Horizons led us to collaborate again on a second symposium, An Epidemiology of Information: Data Mining the 1918 Influenza Pandemic.

Shortly thereafter, we discussed how we could leverage the momentum of our collaboration to develop a workshop uniquely for medical historians, medical librarians, and information technology professionals who are studying medical history and contemporary medicine. We facilitated a conversation between our colleagues at Virginia Tech and the Wellcome Trust, encouraging a collaboration around the workshop. Virginia Tech subsequently applied to the NEH for the necessary funding. The Wellcome Trust would lend support for selected scholars from the United Kingdom to participate; the NLM agreed to host the workshop and offer support in other ways.

In the early spring of 2015, NEH awarded a cooperative agreement to Virginia Tech to support the workshop Images and Texts in Medical History: An Introduction to Methods, Tools, and Data from the Digital Humanities. The organizations involved contributed to publicizing the event. Through its Twitter hashtag #medhistws, the event reached a wide audience, achieved broad and sustained engagement, and reinforced the foundation for future collaboration.

Bottom line: Strategically designed, mutually supportive, and impactful partnerships make great sense. In fact, they can have cascading effects that you may have never originally envisioned. They testify to powerful institutional synergies and the determination of colleagues to build and sustain a collaboration on multiple levels. The NEH/NLM collaboration is an example of one such partnership that has yielded effective public programming, sound financial decisions, and collaborative management. Our investment of time and effort was substantial, but it has yielded lasting dividends for everyone involved, especially the public we serve.

While our collaboration is unique in many ways, the approaches we took to build it, and the values we held to develop it, can operate in any agency culture to serve the greater good.


Further reading re: collaboration? Check out an earlier IDEA Lab post entitled – Innovation for a Safe and Healthier World: A Scientific Collaboration between CDC and the Georgia Institute for Technology

Seeking Public Input on the HHS Open Government Plan for 2016–2018

graphic of two icons and message bubbles

One of the roles that the IDEA Lab and the Office of the Chief Technology Officer perform to serve the U.S. Department of Health and Human Services (HHS) community, our stakeholders, and the public, is that of a ‘virtual village square’ to promote engagement of new ideas about how we do the people’s business. Nearly eight years ago, President Obama emphasized the virtues of opening up government to and of the people through his Open Government Directive.

The core factors he emphasized among federal agencies were the commitment to transparency of government business practices; collaboration among partners in service to the mission; and participation by the public with a voice of action in how their government functions. Each of these factors invoked the need for innovative practices, design of new processes, and adaption of new technologies such as social media to bring our agencies closer to those we serve. Every two years, we’ve worked across all corners of HHS to coordinate our strategies for making government more open. Earlier this summer, we called out for your ideas on getting our plan started. Today, we’re back in the village square to engage you once again and invite you into our open government plan.

In 2009, HHS published its first version of its Open Government plan and now I’m pleased to put forth the Version 4.0 edition in draft form, for public comment. I often hear that federal government agencies are too complex to navigate and that “my idea” doesn’t have a chance of finding a receptive ear or eye. One important lesson I’ve learned from my experiences at HHS is that there are many initiatives that started with that very thing – an idea. Sometimes it’s a person with key knowledge or understanding of a problem that is the perfect fit for what we want on our team to solve that problem. I’ve often heard comments from our team that we can never predict where the best solution is likely to come from.  All to say, your ideas and comments matter to us so we hope you will share them.

In our Version 4.0 plan, we address new areas of open government development including how we are making data available on our information technology and services acquisitions in response to new laws, details around our open source digital code products and services, program achievements and plans for expanding open innovation and crowdsourcing. Consistent with our past traditions, we’re featuring seven new cross-cutting initiatives as our ‘flagships’ that bring new ways of connecting government with the public to the fore.

We invite you to provide us your comments on each section of our plan here. Comments will be accepted until Friday, September 9, 2016. Later this fall we will publish our final plan for the next two years as we continue our open government efforts.

Why Your Inner Kid Holds Your Next Big Idea

The author’s daughter plays in her nursery, discovering her world through trial and error (and frankly, by making a mess).

The author’s daughter plays in her nursery, discovering her world through trial and error (and frankly, by making a mess).

“To raise new questions, new possibilities, to regard old problems from a new angle, requires creative imagination and marks real advance in science.” — Albert Einstein

Peter Pan Was On To Something

In the early mornings and in the evenings, some of my favorite moments at home involve sitting in a gray rocking chair in my almost two-year old daughter’s nursery, watching her play on the floor. I follow her with my eyes as she piles toys on top of each other, tries to force square pegs into round holes, builds towers out of plastic containers, and then, inevitably, knocks the tower down. I watch her as she consumes her small world with her hands and her eyes, figuring things out, without inhibition or fear of failure.

In the world of a child, this is all acceptable behavior. And then, there’s a line we all cross over, a line that separates the child from the adult, and we, inevitably, grow up. When that happens, so quickly, so quietly, so silently, so stealthily, we often lose in the transition from childhood to adult land our sense of playfulness; and our once innate ability to experiment freely and unapologetically becomes less tangible.

Watching my daughter play one evening, I connected the dots (and not just the ones on her multi-colored polkadot rug). I connected the dots that had been in front of me all these months while on detail with the HHS IDEA Lab from the National Institutes of Health (NIH). I connected the dots between playfulness and innovation.

The Path To Innovation is Through Play

At the U.S. Department of Health and Human Services (HHS) IDEA Lab, we use terms like “sandbox,” referring to a safe space in our work environment to develop and pursue ideas and “user-centered design thinking,” an ideation process that can involve colored paper, markers, pipe cleaners, and post-it notes as tools for finding solutions to problems. It is not a coincidence that I’ve heard HHS’s Chief Technology Officer Susannah Fox say that in order to innovate in our government work, we must be playful.

But sitting side by side in a sentence, the words play and work seem to be antonyms. So how do we get them to get along?

A few ways, I believe, and that I’ve learned here in the IDEA Lab, are through risk and experimentation, and I think kids have a lot to teach us about both lessons. If we did not want to verbalize our first words because we were afraid of how they would sound, then we would have never spoken. If we do not test our first ideas, then we will not re-envision how things have always been done, we will not solve problems in new, dynamic, and interesting ways.

Kids are great at overcoming these obstacles and as a result they come up with the best ideas. They are not hemmed in by rules or budgets or details like: does this technology even exist? Do I have access to the materials to make this? Instead of killing the idea immediately, they give it the hope and space to grow. They think big, without boundaries. Incredible opportunities like the 5th Annual Invent It Challenge exist to encourage kids to tune in to this special gift, to think of solutions to real world problems, giving them confidence that their contributions have value.

In April, the IDEA Lab opened their doors to high school students for Take Your Child to Work Day. HHS employees brought their sleepy-eyed teenagers into the IDEA Lab, where they sat around our big pine tables, not quite sure what they would learn here. Once we got them up and out of their seats, groups of kids rotated around the room in speed-dating format, learning about different IDEA Lab programs and initiatives. At the table my colleague and I were manning, we asked the kids to write down (on bright colored post-it notes of course) a response to this prompt:

What Would You Invent to Solve a Health Problem?

They wrote down the ideas and thoughts that would make their small world—their microcosm—a safer, better, and healthier place.

Among the responses:

  • Auto-lacing shoes
  • Parks and playgrounds for disabled people
  • A special kind of hat for migraine headaches

montage of post its about health inventions

 

A special kind of hat for migraine headaches. Genius.

Striking a Balance Between Work and Play

My six month detail with the IDEA Lab sandbox came to a close last week and I feel like I’ve done a lot of growing up there.  As I return to the NIH, I’ve been thinking a lot about what I’m bringing with me (aside from a lot of post-it notes and big, thick markers).

My hope is to be more playful where I was serious, fearless where I was scared, imaginative where I was by-the-book. I hope to bring a renewed sense of energy and appreciation to the work we do in government, work that, regardless of title—researcher, practitioner, communicator, analyst, statistician, technician, educator—is so vital to the future of health and health care in this country. Work that relies on innovation and creative thinking and imagination to keep moving us forward in a space where technology is advancing more quickly than the health infrastructures, policies, regulations, and laws that are currently in place.

Work that ultimately is play in disguise, pushing us to think differently, transforming our outlook from “But that’s how we’ve always done it” to “Yes, we can definitely try a new way.”

I watch my daughter play and her world is this microcosm of controlled chaos. She can make mistakes, she can have the wrong answers, she can babble incoherently as she tries to move her mouth around the right word, and these mistakes and moments of experimentation are welcome. Some of her tests will lead to successes, others failures, but ultimately it’s all part of the process of growing up.

Because my daughter will push the square peg into the round hole and it doesn’t matter that I tell her it doesn’t fit.

She’ll keep trying anyway.